新华社北京9月27日电 题：提升全民健康获得感的关键所在——从2025年中国卫生发展论坛看"三 医"协同 "下一步要持续推动中医药融入分级诊疗体系，发挥其在治未病、重大疾病和康复中的独特作 用。"严华国说。 新华社记者 李恒、彭韵佳 推动"三医"协同发展和治理，是深化医改、提升全民健康获得感的关键所在。 9月27日，2025年中国卫生发展论坛在京举行，主题聚焦"'三医'协同发展和治理：跨部门行动与改 革"。相关部门负责人围绕医疗、医保、医药三大体系的深度融合展开深度对话，并探讨下一步发展方 向。 医疗：从"以治病为中心"转向"以健康为中心" 国家卫生健康委副主任、国家疾控局局长沈洪兵指出，"三医"协同不仅是深化医改的重要目标，更 是推动卫生健康事业高质量发展的关键路径。 党的十八大以来，我国医疗卫生服务体系持续优化，全国已设置13个类别26个国家医学中心、125 个国家区域医疗中心和114个省级医疗中心，优质医疗资源不断向中西部和基层下沉。 "当前，全国338个地市（州、盟）实现医学检查结果互认，互认项目超过200项；紧密型城市医疗 集团和县域医共体建设加快，2024年双向转诊人次达3600万，较2020年增 ...

Core Insights - The new healthcare regulations set to take effect in 2025 will lead to the exclusion of certain medical expenses from insurance reimbursement, impacting patients financially [1][2][10] - The adjustments are necessary due to the increasing financial pressure on the healthcare insurance fund, driven by an aging population and rising medical costs [1][7] Summary by Categories Changes in Reimbursement - Five categories of expenses are likely to be removed from insurance coverage, including: 1. Certain auxiliary examinations and premium medical services, such as high-end health check packages and non-essential imaging tests [4] 2. Inefficient or replaceable medications, particularly those with low clinical value or cheaper alternatives [5] 3. Non-essential rehabilitation treatments and medical devices that do not directly impact disease treatment [6] 4. Specific traditional Chinese medicine treatments that are not deemed essential [6] 5. Non-emergency cross-regional medical services that do not follow referral procedures [6] Rationale Behind Adjustments - The adjustments aim to alleviate the financial strain on the healthcare fund by focusing resources on essential medical services [7] - The policy changes are designed to encourage rational medication use and medical service selection, reducing unnecessary healthcare expenditures [7] - The adjustments also promote the development of the domestic pharmaceutical industry by encouraging the use of innovative and cost-effective medications [7] Strategies for Patients - Patients are advised to understand the new insurance policies and their local variations to avoid unexpected costs [8] - Emphasizing tiered medical care by initially visiting primary healthcare facilities can enhance reimbursement rates [8] - Choosing medications and treatments within the insurance directory can significantly reduce personal expenses [8] - Staying informed about policy changes is crucial for adapting healthcare choices accordingly [8] - Considering supplemental commercial health insurance can provide additional coverage for high-end medical services or specialized medications [9] Positive Signals - Despite the exclusion of certain items from coverage, there are positive developments, such as the inclusion of new cancer drugs and rare disease medications in the insurance directory [10] - The adjustments reflect ongoing efforts to balance the sustainability of the healthcare fund with the medical needs of the population [10]

我国已建成世界上规模最大的医疗服务体系和疾病预防控制体系，居民健康水平持续提升。9月11 日，国务院新闻办举行"高质量完成'十四五'规划"系列主题新闻发布会，介绍"十四五"时期卫生健康工 作发展成就。 努力解决人民群众看病就医的急难愁盼问题 国家卫生健康委主任雷海潮说，"十四五"时期，按照"大病不出省，一般病在市县解决，日常疾病 在基层解决"的工作目标，我国努力解决人民群众看病就医的急难愁盼问题，面向居民提供全方位、全 周期的健康服务。 优化医疗卫生资源配置，推动资源和服务更加贴近居民群众。加强国家医学中心、国家区域医疗中 心和省级区域医疗中心建设，推动优质医疗资源向中西部、东北地区、省域内人口较多的地市和基层延 伸和下沉。截至2024年底，全国医疗卫生机构总量已达到109万所，超过90%的居民在15分钟内能够到 达最近的医疗服务点。 促进分级诊疗，提升医疗服务连续性。实施"分布式检查、集中式诊断"的服务方式，促进化验检查 结果互认。截至今年8月，全国有338个地市（州、盟）互认医学检查化学项目超过200项，县域医学影 像、心电等资源共享中心及中心药房已经普遍建立。全国81个城市的紧密型城市医疗集团正在试点推 ...

推动优质医疗资源向中西部、东北地区、 省域内人口较多的地市和基层进行延伸和下沉 114个省级医疗中心正在建设 推动城市公立医院对口支援帮扶 县级医院和社区卫生服务中心 在11日举行的"高质量完成'十四五'规划"发布会上，国家卫健委主任雷海潮说，按照"大病不出省， 一般病在市县解决，日常疾病在基层解决"的目标，努力解决人民群众看病就医的急难愁盼问题，面向 居民提供全方位、全周期的健康服务。跟随这组海报，一起了解下吧。 新华社权威速览 ·非凡十四五 优化医疗卫生资源配置 推动资源和服务更加贴近居民群众 策划：令伟家 统筹：曹建礼、刘雅萱 制作：佟璐、刘一菲（实习） 【纠错】 【责任编辑:刘阳】 新华社权威速览 ·非风"十四五 促进分级诊疗 提升医疗服务连续性 完善首诊负责制 加强转诊服务 促进化验检查结果互认 取消了医疗机构的门诊预交金 2024年全国双向转诊医疗人次数达3600万 ...

Core Viewpoint - The implementation of the "Medical and Health Strengthening Project" aims to enhance the capacity of grassroots medical services in China, addressing the uneven development and insufficient capabilities of the healthcare system at the grassroots level [2][3]. Summary by Sections Implementation Plan Overview - The State Council officially released the "Implementation Plan for Strengthening Medical and Health Services" on September 10, which was jointly drafted by the National Health Commission and the National Development and Reform Commission [2]. - The plan aims to improve the layout of grassroots medical institutions by 2027, ensuring that residents can reach the nearest medical service point within 15 minutes [3]. Key Goals and Tasks - By 2030, the grassroots medical service system is expected to be further improved, with a significant increase in the service volume of county-level and lower medical institutions [3]. - The plan outlines 12 key tasks focusing on system improvement, service optimization, and strengthening disease control and traditional Chinese medicine [3]. Strengthening Grassroots Medical Services - The plan emphasizes the need for continuous service for key populations, aiming for a 70% management rate for hypertension and type 2 diabetes patients at the grassroots level by 2030 [3][4]. - It also aims to enhance the capabilities of grassroots medical institutions to perform specific medical procedures, such as cataract surgery and dialysis, by 2030 [4]. Resource Allocation and Incentives - The plan encourages the allocation of resources from higher-level hospitals to grassroots institutions, including reserving appointment slots for local healthcare facilities [6]. - It proposes a multi-channel income mechanism for grassroots healthcare institutions, with a reported increase of 15% in medical service revenue for government-run grassroots institutions in 2023, totaling over 140 billion yuan [6][7]. Healthcare Financing and Payment Reforms - The plan includes reforms in medical service pricing and payment methods, promoting a multi-faceted payment system that favors grassroots healthcare institutions [7]. - It emphasizes the need for increased fiscal support for public health institutions and basic public health services, ensuring that government funding is directed towards grassroots healthcare [7].

Core Viewpoint - The article emphasizes that the integration of the "three medical" systems and the downward flow of quality resources are key to addressing the weak capacity of grassroots medical services in China. The government plans to enhance medical insurance reimbursement for grassroots institutions and improve the linkage mechanism for medication between different levels of healthcare facilities [3][4]. Summary by Sections Implementation Plan Overview - The State Council has officially released the "Implementation Plan for Strengthening Basic Medical and Health Services," which aims to enhance the capacity of grassroots medical services during the 14th Five-Year Plan period. The plan is a crucial part of building a healthy China and promoting comprehensive rural revitalization [3][4]. Goals and Objectives - By 2027, the plan aims for a more rational layout of grassroots medical institutions, with a target for residents to reach the nearest medical service point within 15 minutes. By 2030, the service volume of county-level and below medical institutions is expected to increase significantly, and the construction of a hierarchical diagnosis and treatment system will show notable results [4]. Key Tasks - The plan outlines 12 key tasks focusing on system improvement, service optimization, strengthening disease control, and enhancing resource support. Specific targets include achieving a 70% management rate for hypertension and type 2 diabetes patients at the grassroots level by 2030 [4][5]. Financial and Resource Allocation - The plan encourages the participation of social medical institutions in government-purchased basic public health services. It sets quantitative indicators for improving grassroots diagnostic capabilities, such as ensuring that counties with a population of over 50,000 can perform cataract surgeries and dialysis by 2030 [5][6]. Incentives and Reforms - To enhance grassroots medical capabilities, the plan proposes various reforms, including adjusting medical service prices, reforming medical insurance payment methods, and establishing a dynamic adjustment mechanism for staffing. It aims to create a robust incentive mechanism for grassroots development [6][7]. Fiscal Support - The plan highlights the need for increased fiscal investment, ensuring that the government fulfills its financial responsibilities for public health institutions and basic public health services, with a focus on increasing funding for grassroots medical institutions [8].

Core Points - The implementation of the "Healthcare Strengthening Project" aims to enhance grassroots medical service capabilities and is a key component of the "14th Five-Year Plan" [1][2] - The project emphasizes the integration of medical insurance reimbursement benefits towards grassroots healthcare and aims for comprehensive coverage of mobile medical services in under-resourced counties [1][4] Group 1: Implementation Goals - By 2027, the layout of grassroots medical institutions will be more rational, with a goal for residents to reach the nearest medical service point within 15 minutes [2] - By 2030, the service volume of county-level and below medical institutions is expected to increase significantly, with a notable improvement in the hierarchical diagnosis and treatment system [2][3] Group 2: Key Tasks and Metrics - The implementation plan outlines 12 key tasks focusing on system improvement, service optimization, and strengthening disease control and traditional Chinese medicine [2] - Specific targets include achieving a 70% management rate for hypertension and type 2 diabetes patients at the grassroots level by 2030 [2][3] Group 3: Resource Allocation and Support - The plan encourages the allocation of medical resources from higher-level hospitals to grassroots institutions and promotes a "fixed + mobile" service supply model [4] - It also emphasizes the need for a performance evaluation system to enhance the quality of grassroots healthcare services [4][6] Group 4: Financial and Policy Support - The project highlights the importance of increasing financial input from both central and local governments to support public health institutions and basic public health services [6] - Reforms in medical service pricing and insurance payment methods are proposed to ensure that grassroots healthcare institutions receive a larger share of funding [5][6]

三级医院门诊不能再走医保报销了？ 据报道，近日，河南省新乡市医保局印发通知，对市本级三级医疗机构，暂停其城乡居民医保的门诊统 筹服务。 这意味着，在"暂停"政策取消之前，对于新乡市的非就业人群，也即不属于城镇职工医保的参保人而 言，他们在本市的大医院门诊就医，只能使用医保个人账户报销，而无法使用医保统筹资金报销。 尤其是，随着国家日益减少个人账户资金占医保资金总盘子的比例，未来可供他们在大医院门诊看病的 医保资源将变得更为紧缺。在理论上，这也将减少"越级"看病的患者数量，增加"基层首诊"比例。 事实上，新乡市的政策并非个例。 2016年12月，《"十三五"卫生与健康规划》提出要实行分级诊疗，提高基层医疗服务能力，控制三级医 院普通门诊规模，由基层医疗卫生机构逐步承担公立医院的普通门诊。青海省便第一时间跟进，全部取 消了西宁地区三级公立医院的简易门诊。 广东省则早在2016年5月16日就印发了《广东省加快推进分级诊疗制度建设实施方案》，明确要求推动 专家、名医到基层医疗卫生机构提供诊疗服务或到基层开办医生工作室，逐步降低大型医院门诊比例， 鼓励大型医院逐步取消门诊。 2022年，海南省提出"逐步取消三级公立医院 ...

Core Perspective - The release of the "Healthy China 2030 Planning Outline" signifies a profound shift in China's health care system from a "disease-centered" model to a "people-centered" approach, emphasizing prevention and the need for a robust preventive medical system [1] Group 1: Resource Allocation and Optimization - The concentration of quality medical resources in large public hospitals has led to high operational loads, with 9.55 billion total medical visits reported in 2023, many of which are for routine checks rather than urgent care [2][3] - The growth of professional health examination institutions provides an efficient "diversion" channel, allowing public hospitals to focus on critical medical challenges while meeting preventive health needs in a more optimized environment [3] Group 2: Enhancing Public Health Awareness - The entry of social capital into the health examination market has significantly increased service accessibility and frequency, transforming annual health checks from a privilege to a standard practice for the majority [4] - Market competition has driven profound changes in service models, with institutions focusing on improving service experiences and educating the public on health management tailored to different age groups [4] Group 3: Innovation in Service Models - The innovations in service models and management mechanisms by private institutions contribute qualitatively to the healthcare system, creating a "catalytic" effect that enhances overall service quality [5][6] - These institutions are adopting digital health accounts and integrating AI technologies into various health services, improving diagnostic efficiency and pushing for technological advancements in the industry [6] Group 4: Collaborative Ecosystem - The collaboration between public and private healthcare entities is essential for deepening the preventive medical system, ultimately aiming for comprehensive health and well-being for all citizens [7]

Core Insights - The launch of the health station in Yangchun City is part of the "High-Quality Development Project for Hundreds of Counties, Thousands of Towns, and Ten Thousand Villages" [1] - The health station is perceived as a "medical convenience store" by residents, significantly enhancing their daily convenience and sense of safety [1] - The health station serves as the "first gatekeeper" for residents' health and an effective referral point for graded diagnosis and treatment [1] Summary by Sections Health Station Operations - The health station provides free health check-up services, including blood pressure measurement and routine blood tests, particularly benefiting the elderly and those with mobility issues [1] - Currently, there are six operational health stations in Yangchun City, with three more under construction, expected to open by the end of the year [2] Future Plans - The health station aims to integrate health records through information technology, guiding patients with common and chronic diseases to seek initial treatment and rehabilitation at the grassroots level [1] - Plans are in place to introduce expert resources from secondary and tertiary hospitals for consultations, enhancing family doctor services and creating a "home-based" health service network [1]